Waiver, Release, and Assumption of Risk (Self lead exercise)
This form is an important legal document. It explains the risks you are assuming by participation in an exercise program. It is important that you read and understand it completely. After you have done so, please print your name legibly and sign in the spaces provided at the bottom.
Waiver, Informed Consent, and Covenant Not to Sue
I, "Client", have volunteered to participate in physical exercise under the direction of Brunner Athletic Development & Health Fitness, which will include, but may not be limited to, weight and/or resistance training. In consideration of Brunner Athletic Development & Health Fitness’s agreement to instruct, assist, and train me, I do here and forever release and discharge and hereby hold harmless Mr. Dusten Brunner, and his respective agents, heirs, assigns, contractors, and employees from any and all claims, demands, damages, rights of action or causes of action, present or future, arising out of or connected with my participation in this or any exercise program including any injuries resulting there from. THIS WAIVER AND RELEASE OF LIABILITY INCLUDES, WITHOUT LIMITATION, INJURIES WHICH MAY OCCUR AS A RESULT OF (1) EQUIPMENT THAT MAY MALFUNCTION OR BREAK (2) ANY SLIP, FALL, DROPPING OF EQUIPMENT AND (3) OUR NEGLIGENT INSTRUCTION OR SUPERVISION.
Assumption of Risk
I, "Client" , recognize that exercise might be difficult and strenuous and that there could be dangers inherent in exercise for some individuals. I acknowledge that the possibility of certain unusual physical changes during exercise does exist. These changes include abnormal blood pressure; fainting; disorders in heartbeat; heart attack; and, in rare instances, death.
I understand that as a result of my participation, I could suffer an injury or physical disorder that could result in my becoming partially or totally disabled and incapable of performing any gainful employment or having a normal social life.
I recognize that an examination by my physician must be obtained prior to involvement in this exercise program.
I acknowledge and agree that I assume the risks associated with any and all activities and/or exercises in which I participate.
I ACKNOWLEDGE THAT I HAVE THOROUGHLY READ THIS WAIVER AND RELEASE AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. BY SIGNING THIS DOCUMENT, I AM WAIVING ANY RIGHT I OR MY SUCCESSORS MIGHT HAVE TO BRING A LEGAL ACTION OR ASSERT A CLAIM AGAINST MR. DUSTEN BRUNNER or OTHERS REFERRED TO IN THIS DOCUMENT FOR ANY NEGLIGENCE OR THAT OF OUR EMPLOYEES, AGENTS, OR CONTRACTORS.
Photography and Audio/Video Recording
I hereby give Brunner Athletic Development & Health Fitness permission to video tape, photograph, and record my image and or likeness. I understand that such taping or recording may be used at the sole discretion of Brunner Athletic Development & Health Fitness. I also understand by giving permission is in no way an endorsement of Brunner Athletic Development & Health Fitness or any product(s) distributed by Brunner Athletic Development & Health Fitness.
I, "Client" , have requested that Dusten Brunner conduct my personal training sessions in my home or office, and hereby agree as follows:
I may provide some or all of the exercise and/or fitness equipment to be used in connection with my fitness program and the associated workouts (the “Equipment”).
I acknowledge and agree that Dusten Brunner has not inspected the Equipment, and that I have sole custody and control of the area in my home or office where it is to be used and stored, and that I am solely responsible for the condition and maintenance of the Equipment.
I have sole control over the area in my home or office where my workouts are to be performed.
I hereby assume any and all risks arising from or connected with any hazardous condition, known or unknown, in my home or office, in the specific area in which the workouts are conducted or otherwise, that may result in any injury during, or thereafter associated with, any workout with Dusten Brunner. Further, I agree to hold Dusten Brunner harmless from any loss or damage resulting from, or associated with, any injury or condition that I sustain resulting from any such condition.
I hereby assume any and all risks associated with the location, design, and material condition of the Equipment, and agree to hold Dusten Brunner harmless from any loss or damage resulting from, or associated with, any injury or condition that I sustain resulting from the location, design, material condition, or use of the Equipment.
This waiver and release of liability includes, without limitation, injuries which may occur as a result of (a) equipment that may malfunction or break; (b) any slip, fall, or dropping of equipment; (c) any improper maintenance of equipment or facilities; (d) any hazardous condition that may exist on the premises, including the specific workout area, my home or office, and the surrounding property; and (e) your negligent instruction or supervision.
I acknowledge that I have thoroughly read this document and fully understand that it is a release of liability. By signing this document, I am waiving any right I or my successors might have to bring a legal action or assert a claim against Dusten Brunner for your negligence or that of your employees, agents, or contractors.
All Terms and Conditions are subject to change. The most current version of these Terms, Conditions, and Policies will be posted on www.BrunnerAthleticD.com.